Making sense of some healthcare reform language

This healthcare reform debate has gotten so complex, it's easy to be confused by the terminology. Here are brief explanations of some of the concepts being discussed. All regard money and competition, rather than care itself.

Single payer system -- The purpose of a single payer system is to provide healthcare to everyone without regard to individual cost. The government collects taxes to pay for it, and there is no competition. When costs go up, taxes are raised. Medicare is a single payer system.

Health insurance -- Like every business, an insurer's goal is to bring in more money than it spends. Insurers compete with each other for customers. Today they struggle to bring in enough money to cover what they expect to pay out. To stay in business, they must either raise their premiums, or lower their administrative costs including salaries and jobs, or cut corners on the kinds and amount of care they will cover.

Rationing -- Rationing is denial of care, usually due to cost. If any payer - government or insurer - refuses to pay for appointments, treatments or tests, then care has been rationed. Rationing is not a new concept; it has been taking place for years.

Insurance co-ops -- When a large group of people with similar insurance needs pool their resources to buy insurance, it's called a cooperative, or co-op. Groups such as farmers or small business owners have established co-ops. The larger the group, the lower the cost or the better the benefits. People who believe in insurance competition like the idea of co-ops instead of a public option. They believe it is more fairly competitive.

Public option insurance -- A public option would be a hybrid, government-sponsored insurance. Due to the government's sheer size and negotiating power, its premiums would be low, making coverage more affordable. A public insurance option would compete against all other insurers, but insurers don't want that competition. They fear that even the people who can afford their higher premiums today will choose instead to pay lower premiums for the public option insurance.

Insurance exchanges -- Today, employed people and those who can afford insurance may have only a few options in their location from which to choose. An exchange, likely sponsored by a state or the federal government, would increase the number of options and the amount of competition, which would lower costs. Lower costs would mean more people could afford insurance.

When we understand these terms and concepts, then it's easier to assess the reform options being discussed. Find expanded definitions and more healthcare reform concepts at www.EveryPatientsAdvocate.com. 

Trisha Torrey is Every Patient's Advocte, host of University Hospital's HealthLink on Air radio program, and patient empowerment expert at About.com. Learn more at everypatientsadvocate.com.